FDA says green onions may pose hepatitis A risk

Foodborne Disease

Nov 17, 2003 (CIDRAP News) – The Food and Drug Administration has advised the public to consider avoiding raw or lightly cooked green onions (scallions) in the light of evidence linking them to recent hepatitis A outbreaks.

In September hepatitis A outbreaks associated with raw or lightly cooked green onions served in restaurants occurred in Tennessee, North Carolina, and Georgia, the FDA said. Another outbreak that so far has involved more than 500 people in Pennsylvania is ongoing. The outbreak has been linked with a Chi Chi's restaurant, but the FDA said it has not been tied to a specific food.

The agency said consumers who are concerned about the risk of getting hepatitis A from green onions should cook them thoroughly, which reduces or eliminates the virus. At restaurants and delicatessens, consumers should request that raw or lightly cooked green onions not be added to their food. Foods like freshly prepared salsa and green salads often contain green onions.

The green onions implicated in the Tennessee outbreak apparently came from Mexico, and the FDA has been working with Mexican authorities to assess the situation, officials said. The FDA, Centers for Disease Control and Prevention, and Pennsylvania Department of Health are investigating the Pennsylvania outbreak.

A Pennsylvania Health Department official reported that 510 cases of hepatitis A, with three deaths, had been confirmed in the Pennsylvania outbreak as of Nov 15, according to an Associated Press report. The official, Richard McGarvey, said more infections were expected because people who contract the disease typically don't experience symptoms for 28 to 30 days.

The state is offering antibody inoculations to people who ate at the restaurant, at the Beaver Valley Mall 25 miles northwest of Pittsburgh, after Oct 22, according to the AP story. About 8,500 people have had the shots, the report said.

The FDA said people who have recently eaten raw or lightly cooked green onions do not need to take any specific measures but should monitor their health. Hepatitis A is usually mild and is characterized by jaundice, fatigue, abdominal pain, loss of appetite, nausea, diarrhea, and fever, officials said. The disease is sometimes severe, especially in people with liver disease.

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